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Dermatologic Manifestations of Glomus Tumor Workup

  • Author: Jon H Meyerle, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: May 26, 2016

Laboratory Studies

Routine laboratory studies are not helpful in patients with glomus tumors. The rare exception is in patients with widely disseminated lesions in which platelet sequestration is a concern. In these patients, a CBC count is indicated.


Imaging Studies

While the diagnosis of a glomus tumor is often made on clinical and histologic grounds, imaging may prove useful,[22] especially in cases in which the diagnosis is in doubt.

Plain radiography has been reported to reveal bony erosions, especially in the case of subungual lesions. Ultrasonography, especially color-duplex ultrasonography, has a high detection rate and no false-negative results, at least in one series; additionally, ultrasonography can detect glomus tumors as small as 2 mm.[23, 24, 25]

MRI has also been studied and may be particularly useful for the detection of multiple tumors[26, 27] or in cases in which the diagnosis or specific location of the lesion is in question.[10]  High-resolution MRI has proven useful as well.[28, 29]


Histologic Findings

Solitary and multiple glomus tumors have distinct histopathologic features.

Solitary lesions appear mostly as solid, well-circumscribed nodules surrounded by a rim of fibrous tissue. They contain endothelium-lined vascular spaces surrounded by clusters of glomus cells. The glomus cells are monomorphous, round or polygonal cells with plump nuclei and scant eosinophilic cytoplasm. Note the images below.

Glomus tumor (4X). The tumor is composed of unifor Glomus tumor (4X). The tumor is composed of uniformly round, small, glomus cells with pale eosinophilic cytoplasm associated with conspicuous vasculature.
Glomus tumor (10X). Glomus tumor (10X).

Multiple lesions are less well circumscribed and less solid appearing than their solitary counterparts. Multiple lesions have the overall appearance of a hemangioma. They contain multiple irregular, dilated, endothelium-lined vascular channels that contain red blood cells. The vascular spaces are larger than those in a solitary glomus tumor. Small aggregates of glomus cells are present in the walls of these channels and in small clusters in the adjacent stroma. Multiple glomus tumors have more narrow and focal aggregates of glomus cells than solitary lesions. The overall appearance of multiple glomus tumors accounts for their alternate name, glomangiomas. Note the images below.

Glomangioma (2X). In this variant, blood vessels p Glomangioma (2X). In this variant, blood vessels predominate.
Glomangioma (10X). Note the typical small, round g Glomangioma (10X). Note the typical small, round glomus cells, often distributed in a monolayer or bilayer within the vessel walls.

Glomangiosarcomas resemble benign glomus tumors. However, glomangiosarcomas have more atypia, pleomorphism, and mitotic figures, and they have an invasive growth pattern. Most often, foci of benign glomus tumor are correlated with malignant lesions.

Contributor Information and Disclosures

Jon H Meyerle, MD Assistant Professor, Department Dermatology, Uniformed Services University of the Health Sciences; Assistant Professor, Department of Dermatology, Johns Hopkins University School of Medicine; Chief, Immunodermatology, Walter Reed National Military Medical Center

Jon H Meyerle, MD is a member of the following medical societies: American Academy of Dermatology, Sigma Xi

Disclosure: Nothing to disclose.


Erin L Spillane, MD Staff Dermatologist, Department of Dermatology, Womack Army Medical Center

Erin L Spillane, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Christen M Mowad, MD Professor, Department of Dermatology, Geisinger Medical Center

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, American Academy of Dermatology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Abby S Van Voorhees, MD Assistant Professor, Director of Psoriasis Services and Phototherapy Units, Department of Dermatology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania

Abby S Van Voorhees, MD is a member of the following medical societies: American Academy of Dermatology, Women's Dermatologic Society, National Psoriasis Foundation, American Medical Association, Phi Beta Kappa, Sigma Xi

Disclosure: Received honoraria from Amgen for consulting; Received honoraria from Abbott for consulting; Partner received salary from Merck for management position; Received honoraria from Abbott for speaking and teaching; Received honoraria from Amgen for review panel membership; Received honoraria from Centocor for consulting; Received honoraria from Leo for consulting; Received none from Merck for other.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Omar P. Sangueza, MD, and Michael B. Reynolds, MD, to the original writing and development of this article.

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Glomus tumor.
Multiple glomus tumors.
Glomus tumor (4X). The tumor is composed of uniformly round, small, glomus cells with pale eosinophilic cytoplasm associated with conspicuous vasculature.
Glomus tumor (10X).
Glomangioma (2X). In this variant, blood vessels predominate.
Glomangioma (10X). Note the typical small, round glomus cells, often distributed in a monolayer or bilayer within the vessel walls.
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